GRAND RAPIDS — Grand Valley Health Corp.’s decision to get out of the HMO business follows continued losses and years of dwindling membership, combined with pressures brought on by the federal Affordable Care Act.

The growth of private health exchanges and the migration of more employers to self-insured health benefits are the key trends Michigan Association of Health Plans Executive Director Rick Murdock is watching for 201

An American Medical Association report that again ranks Michigan’s health-insurance market as one of the least competitive in the nation provides even more fodder for argument between Blue Cross Blue Shield of Michigan and its competitors.

Further action on transitioning Blue Cross Blue Shield of Michigan to a not-for-profit mutual insurer won’t come until after the November election, giving those who object to the current version of the legislation time to lobby for more changes.